| NPI | 1154098531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID p9149) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 10493705-1701) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |